A patient is about to receive a morning dose of digoxin with an apical pulse of 59 beats/minute. What should the LPN do first?

A patient is about to receive a morning dose of digoxin with an apical pulse of 59 beats/minute. What should the LPN do first?

• A. Administer the medication
• B. Retake the apical pulse
• C. Hold the medication and notify the RN
• D. Contact the pharmacist

Answer: (C)

In this scenario, the patient is about to receive digoxin, which is a medication that requires careful monitoring of the heart rate due to its potential to cause bradycardia. An apical pulse of 59 beats per minute is considered lower than the recommended threshold for safe administration of digoxin, which is usually not given if the pulse is below 60 beats per minute in adults. The first priority for the LPN should be to hold the medication and notify the RN. This is essential because administering digoxin at this pulse rate could pose significant risks to the patient, including potential life-threatening arrhythmias. By holding the medication, the LPN ensures patient safety, and notifying the RN allows for further evaluation and decision-making concerning the patient's condition and treatment plan. While it might seem reasonable to retake the pulse, the initial reading is already below the critical threshold, and action should be taken rather than simply confirming the low pulse. Administering the medication or contacting the pharmacist would not be appropriate until a thorough assessment has been made by a licensed nurse.

In this scenario, the patient is about to receive digoxin, which is a medication that requires careful monitoring of the heart rate due to its potential to cause bradycardia. An apical pulse of 59 beats per minute is considered lower than the recommended threshold for safe administration of digoxin, which is usually not given if the pulse is below 60 beats per minute in adults.

The first priority for the LPN should be to hold the medication and notify the RN. This is essential because administering digoxin at this pulse rate could pose significant risks to the patient, including potential life-threatening arrhythmias. By holding the medication, the LPN ensures patient safety, and notifying the RN allows for further evaluation and decision-making concerning the patient's condition and treatment plan.

While it might seem reasonable to retake the pulse, the initial reading is already below the critical threshold, and action should be taken rather than simply confirming the low pulse. Administering the medication or contacting the pharmacist would not be appropriate until a thorough assessment has been made by a licensed nurse.